Date:   4/21/2014 12:20:50 PM ( 10 y ago)
Hits:   1,512
URL:   https://www.curezone.org/forums/fm.asp?i=2168208

More and more people here have been realizing that low-carb diets have been ruining their health and only when they started increasing their carbohydrate intake did their health start improving.

But some people have complained of bad reactions when trying to reintroduce more carbs back into their diet, particular those with later-stage "AF". Because of this, it has forced them to stay on their current high-fat/low-carb diets and, as a result, their health continues to suffer.

The most likely reason reintroducing carb foods like fruit and starches gave these people problems is Refeeding Syndrome.

Why does this particularly effect people with later-stage "AF"? Well, first you need to know what the stages of "AF" really are and then what "AF" really is.

Below talks about Refeeding Syndrome and why some who are severely calorie-restricting, or have in the recent past, may have a particular hard time reintroducing back carbs into their diet.



Refeeding syndrome is a syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished.

Any individual who has had negligible nutrient intake for more than 5 consecutive days is at risk of refeeding syndrome. Refeeding syndrome usually occurs within four days of starting to feed. Patients can develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications.

This syndrome can occur at the beginning of treatment for anorexia nervosa when patients have an increase in calorie intake and can be lethal. The shifting of electrolytes and fluid balance increases cardiac workload and heart rate.

Treatment
Refeeding syndrome can be fatal if not recognized and treated properly.
Refeeding syndrome occurs most commonly in those who have lost weight rapidly. Refeeding syndrome occurs most commonly in those who have lost weight rapidly.

Patients who have been starved for some time often experience gastrointestinal disturbance during refeeding, in particular colicky abdominal pain, reflux symptoms, nausea and early satiety. To help manage this, patients are often prescribed pro-kinetic agents such as domperidone or metoclopramide, as well as acid suppressants such as omeprazole. This may be of particular importance in patients suffering from anorexia nervosa, who can find these symptoms particularly distressing.

See also Minnesota Starvation Experiment where some effects of refeeding were documented.

http://en.wikipedia.org/wiki/Refeeding_syndrome


Hypophosphatemia is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood. The condition has many causes, but is most commonly seen when malnourished patients are given large amounts of carbohydrates, which creates a high phosphorus demand by cells, removing phosphate from the blood (refeeding syndrome).

http://en.wikipedia.org/wiki/Hypophosphatemia


Hypophosphataemia Causes
Inadequate intake:
- Poor intake may be due to poor diet, including eating disorders such as anorexia nervosa, difficulty with chewing and swallowing, and alcoholism.
- Malnutrition due to malabsorption or persistent vomiting.

http://www.patient.co.uk/doctor/Hypophosphataemia.htm


Anorexia Nervosa Diagnosis

The first step toward a diagnosis is to admit the existence of an eating disorder. Often, the patient needs to be compelled by a parent or others to see a doctor because the patient may deny and resist the problem. Some patients may even self-diagnose their condition as an allergy to carbohydrates, because after being on a restricted diet, eating carbohydrates can produce gastrointestinal problems, dizziness, weakness, and palpitations. This may lead such people to restrict carbohydrates even more severely.
It is often extremely difficult for parents and patients to admit that a problem is present.

Treatment for Anorexia - Restoring Normal Weight and Nutritional Intervention

Nutritional intervention is essential. Weight gain is associated with fewer symptoms of anorexia and with improvements in both physical and mental function. Restoring good nutrition can help reduce bone density loss. Raising the level of energy available to the body by balancing food intake and exercise can normalize hormonal function. Restoring weight is also essential before the patient can fully benefit from additional psychotherapeutic treatments.

Goals for Weight Gain and Good Nutrition. A weight-gain goal of 2 - 3 pounds a week for hospitalized patients, and 0.5 - 1 pound a week for outpatients, is strongly encouraged. Patients typically begin with a calorie count as low as 1,000 - 1,600 calories a day, which is then gradually increased to 2,000 - 3,500 calories a day. Patients may initially experience intensified anxiety and depressive symptoms, as well as fluid retention, in response to weight gain. These symptoms decrease as the weight is maintained.

Excessive amounts of glucose solutions can cause phosphate levels to drop severely and trigger a condition called hypophosphatemia. Emergency symptoms include irritability, muscle weakness, bleeding from the mouth, disturbed heart rhythms, seizures, and coma.

http://umm.edu/health/medical/reports/articles/eating-disorders


Anorexia_nervosa Treatment - Dietary
Calories: Patients must be fed adequate calories at a measured pace for improvement of their condition to occur. The best level for calorie intake is to start by providing 1200 to 1500 calories daily and increasing this amount by 500 each day. This process should continue until the level of 4000 calories (for male patients) or 3500 calories (for female patients) is achieved. This system should also decrease effects such as apathy, lethargy, and food-related obsessions.

http://en.wikipedia.org/wiki/Anorexia_nervosa#Dietary
 

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